15-4, Miscellaneous Changes | Texas Health and Human Services

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Revision Notice 15-4, Effective October 14, 2015

The following change(s) were made:

Section	Title	Change
5110	Enrollment Forms	Deletes a reference to Form 3049 (now obsolete as the information is contained in Form 3050) and changes the title of Form 3050, DAHS Health Assessment/Individual Service Plan.
5130	Case Manager Service Planning Process	Deletes a reference to Form 2060, Needs Assessment Questionnaire and Task/Hour Guide.
5210	Referrals	Deletes references to Form 3049 and updates the title of Form 3050.
5211	Health Assessment	Deletes references to Form 3049, updates the title of Form 3050 and information for using Form 3050.
5212.1	Initial DAHS ISP	Deletes references to Form 3049 and Form 3055, and updates the title of Form 3050 and information for using Form 3050.
5212.2	Updates to DAHS ISP	Updates the title of Form 3050.
5212.3	Initial an Ongoing DAHS ISP	Updates the title of Form 3050.
5213.1	Initial Physician’s Orders for Enrollment of Individual into DAHS	Updates the title of Form 3050.
5213.3	Physician’s Orders and Signature	Deletes if the physician does not want a copy of the health assessment document, the physician’s refusal of a copy must be in writing.
5220	Regional Nurse Prior Approval for Case Manager Referral	Updates the title of Form 3050 and changes “acute” to “chronic” medical condition.
5310	Facility Response to Facility-Initiated Referrals	Deletes references to Form 3049 and updates the title of Form 3050.
5411	Corrections of Critical Omissions or Errors	Deletes a reference to Form 3049 and updates the title of Form 3050.
5700	Facility Responsibilities	Deletes a reference to Form 3049 and updates the title of Form 3050.
6220	Record Retention	Updates the title of Form 3050.
6260	Service Delivery Documentation Requirements	Updates the title of Form 3050.